FIELD OF THE INVENTION
[0001] The present invention relates to guidewires for navigating through the human vasculature.
The present invention has even further relation to such guidewires used for delivering
medical devices, such as balloon catheters, to a target site with the vasculature.
The present invention has even further relation to such guidewires made from superelastic
materials.
BACKGROUND OF THE INVENTION
[0002] Percutaneous transluminal coronary angioplasty (PTCA) is a therapeutic medical procedure
used to increase blood flow through the coronary artery and can often be used as an
alternative to coronary by-pass surgery. An elongated catheter having a deflated balloon
at its distal end is guided through a patient's cardiovascular system to the coronary
artery of the heart. The balloon is inflated to compress deposits that have accumulated
along the inner walls of the coronary artery to widen the artery lumen and increase
blood flow. Typically, the balloon catheter is guided to the specific area within
the vessel by an elongated guidewire. The guidewire is inserted into the patient and
routed through the cardiovascular system and can be viewed on an x-ray imaging screen.
[0003] The path the guidewire follows during this procedure is often tortuous. The distal
tip of the guidewire is flexible to avoid damaging the inner walls of the blood vessels
which the guidewire tip contacts along the tortuous path. The distal tip is often
pre-bent to a desired configuration so that the guidewire can be inserted into branching
blood vessels along its path. The physician must be able to orient the tip so it can
be pushed into these branching blood vessels. Examples of prior art guidewires are
shown in U.S. Patent 4,846,186 issued to Box et al. on July 11, 1989 and U.S. Patent
5,267,574 issued to Viera et al. on December 7, 1993.
[0004] Such guidewires typically have a core made from stainless steel or the like and coated
with a lubricity enhancing agent, such as Teflon®. The distal end of the guidewire
is often not coated as such and usually comprises one or two tapered portions which
reduce the diameter of the core wire at its distal end. The distal most portion of
the core wire is then flattened to form a ribbon tip which makes it easier for a physician
to form it into a desired shape. A flexible coiled wire spring surrounds the distal
tip of the core wire and is attached thereto. The coil separates from the core wire
for a predetermined length and is attached proximal to the flattened distal portion
of the core wire.
[0005] Among the difficulties sometimes encountered with conventional guidewires, is the
possibility that the distal end of the guidewire may kink as it is advanced through
the patient's vasculature. Kinking is the result of a plastic deformation of the guidewire
and usually is characterized by a sharp deformation or point bend of the very distal
section of the wire. Such a deformation may result from attempting to pass a guidewire
through a relatively hard, calcified lesion, a mostly occluded vessel section or a
very tortuous vascular section. The wire may kink or bend back upon itself in a condition
referred to as prolapse. Thereafter, the wire may return to its original shape, or
it may remain permanently deformed if, during the bending, the wire material is bent
beyond its elastic limit.
[0006] Once permanent kinking occurs, the guidewire is usually discarded because it cannot
be adequately straightened for use. Consequently, the procedure may have to be aborted
and a new guidewire selected, reinserted, and again manipulated and advanced to the
target site. Reinsertion of another guidewire increases the risk of trauma to the
blood vessels. Unless great care is taken, the blood vessels can be seriously damaged.
[0007] Recently, guidewires having core wires which are made from superelastic alloys such
as Nitinol® have become more popular. An example of such a wire is given in U.S. Patent
5,411,476 issued to Abrams et al. on May 2, 1995. The superelastic nature of the core
wire allows the metal to be deformed and restrained in the deformed condition, causing
the alloy to transform from an austenite phase to a martensite phase. However, once
the restraint on the superelastic member is removed, the stress is reduced and the
core returns to its original undeformed shape by the transformation back to the original
phase.
[0008] However, as mentioned above it is desirable to provide a guidewire having a curvature
or some other shape at its distal end to assist the physician in introducing, advancing
and steering the guidewire and catheter to the target site in the blood vessel. One
problem with guidewires made of superelastic materials is that, unlike the conventional
prior guidewires, they cannot be readily formed, immediately prior to the procedure,
into a shape desired for a specific procedure. This is because the superelastic property
which is so desirable in prevention of kinking serves to preclude formability by the
physician. Accordingly, there is a need for a guidewire that combines the advantages
of guidewires formed of superelastic alloys with the ability to form or shape the
distal end of the guidewire immediately prior to use by the physician.
[0009] Prior art solutions to this problem have included using a malleable safety wire extending
between the tip of the core to the extreme distal end of the guidewire. Others have
suggested coating the distal end of the guidewire with a malleable material. Examples
of such guidewires are presented in U.S. Patent 5,368,049 issued to Raman et al. on
November 29, 1994. EP0 739 641 discloses a guidewire with a sleeve member of formable
material around a central core wire. Both the sleeve and the core wire are situated
within the distal- area of a coiled spring wire. However, many superelastic materials,
such as Ni-Ti alloys, do not weld very well, especially to malleable materials such
as stainless steel. This could cause the safety wire mentioned above to detach from
the core wire, possibly posing a danger to the patient. In addition, the poor welding
properties of such materials make the coating suggestion impractical for manufacturing.
[0010] There has, therefore, been a need to have a superelastic guidewire with a shapeable
tip which can be better manufactured and is of a simpler design. The present invention
provides such a guidewire and overcomes the shortcomings of the prior art.
SUMMARY OF THE INVENTION
[0011] In accordance with the present invention there is provided a guidewire for navigating
through the human vasculature. The guidewire has a distal end for insertion into the
body, and a proximal end. The guidewire is made from a core wire formed from a superelastic
material and has distal and proximal ends. The core wire has a bore adjacent its distal
end, and the bore has a predetermined size and shape. The guidewire further includes
a member formed from a malleable material which is inserted within the bore. Whereby,
after the member is bent, the shape of the distal end of the core wire changes without
elastically returning to its original shape. Lastly, the guidewire includes a cover
which surrounds the member and portions of the core wire immediately adjacent thereto.
BRIEF DESCRIPTION OF THE DRAWINGS
[0012] While the specification concludes with claims which particularly point out and distinctly
claim the subject matter forming the present invention, it is believed that the invention
will be better understood from the following description of the preferred embodiment
taken in conjunction with the accompanying drawings wherein:
Figure 1 is a fragmented and sectional illustration of a guidewire in accordance with
the present invention, showing the guidewire in a straight position.
Figure 2 is a view similar to that of Figure 1, but showing the guidewire in its bent
position.
DETAILED DESCRIPTION OF THE INVENTION
[0013] Referring to the drawings wherein like numerals indicate the same elements throughout
the views, there is shown in Figure 1 a guidewire 10 in accordance with the present
invention. Guidewire 10 has a distal end 12, for insertion into the human vasculature,
a proximal end 14, typically used for torquing the guidewire while guiding it through
the human body, and a longitudinal axis 16 extending therebetween. Guidewire 10 includes
a core wire 20 having a distal end 22 and a proximal end 24. Core wire 20 has a first
or proximal uniform diameter portion 26 with a diameter in the range 0.23-0.96 mm
(0.009-0.038 inch), and which extends well over half the length of the guidewire.
To improve the depiction of details of the distal portion of the guidewire 10, this
uniform diameter elongated portion 26 has been sectioned and a major portion of its
length deleted from FIG. 1. The total length of the uniform diameter portion 26 is
approximately 148 cm. of the total guidewire length of 180 cm. Distal to portion 26,
the core wire has a tapered portion 28 and a second uniform diameter portion 29, distal
to portion 28. Distal end 12 could include a hemispherical bead at the extreme distal
end, having a slightly larger diameter than the core wire immediately adjacent thereto.
Such beads are well known in the art, such as the one disclosed in U.S. Patent 4,538,622.
[0014] Core wire 20 is preferably made from a superelastic material. As will be appreciated
by those skilled in the art, it is not necessary to have the entire length of the
core wire made from a superelastic material. Alternatively, only a predetermined portion
of the distal end of the core wire need be made from such a material. An example of
such a guidewire is described in U.S. Patent 5,341,818 issued to Abrams et al. on
August 30, 1994. Suitable superelastic materials are well known by those skilled in
the art, including Nitinol®. That is, the core wire is preferably made of an alloy
material comprising about 40 to about 49% titanium and the balance nickel and up to
10% of one or more other alloying elements. The other alloying elements may be selected
from the group consisting of iron, cobalt, vanadium and copper. The alloy can contain
up to about 10% copper and vanadium and up to 3% of the other alloying elements. The
addition of nickel above the equal atomic amounts with titanium and the other identified
alloying increase the stress levels at which the stress-induced austenite-to-martensite
transformation occurs and ensures that the temperature at which the martensite phase
transforms to the austenite phase is well below human body temperature, and preferably
below room temperature, so that austenite is in a stable phase throughout a procedure.
The excess nickel and additional alloying elements also help to provide an expanded
strain range at very high stresses when the stress induced transformation of the austenite
phase to the martensite phase occurs.
[0015] Guidewire 10 preferably has a means for making the proximal end 24 of the core wire
20 more rigid or stiff than the distal end 22. In Figure 1, this means is a hypotube
60, covering a predetermined portion of the proximal end of the core wire 30. Preferably,
tube 60 is made from a material which has a greater rigidity than the material of
the core wire such as stainless steel. This added stiffness helps the doctor torque
and guide the guidewire to the target area within a vessel. The guidewire 10 also
preferably includes a means for making its distal end 12 more lubricious. In Figure
1, this is shown as a lubricious coating 62 made from any number materials known in
the art including Teflon, any number of polymers including Nylon and Estane, or a
hydrophilic coating. The coating could cover only the distal end of the guidewire
as shown in Figure 1, or could cover the entire guidewire. In addition, if a hemispherical
bead is present at the extreme distal end of the core wire, the coating may or may
not cover it. Core wire 20 includes one or more lateral grooves 23, which create a
mechanical lock between coating 62 and core wire 20. Coating 62 preferably fills in
the lateral groves. This helps to prevent the Teflon sleeve or coating 62 from sliding
with respect to the core wire 20.
[0016] Distal end 22 of core wire 20 has a longitudinal bore 30 along its outer surface
21. Bore 30 can be manufactured into the core wire by any method known to those skilled
in the art, including grinding and pressing. Bore 30 has a predetermined size, including
a predetermined axial height as measured perpendicular to longitudinal axis 16, and
a predetermined shape. The axial height and width of the bore preferably ranges from
about 0.012-0.076 mm (0.0005 and 0.003 inch) and its length along the longitudinal
axis preferably ranges from about 6.4-25.4 mm (0.25 inch to 1 inch).
[0017] Guidewire 10 further includes a member 40, formed from a malleable material, such
as stainless steel. Member 40 has an axial height which is preferably not substantially
greater then the axial height of the bore. This is so the surface of the guidewire
is smooth along the bore/member area and ensures that the member does not increase
the diameter of the wire at that point. Member 40 is substantially entirely inserted
within bore 30. Preferable, member 40 has the same shape as bore 30 and is just slightly
smaller than bore 30 so that it fits snugly within bore 30.
[0018] As seen from Figure 2, member 40 allows the distal tip 12 of guidewire 10 to be formed
into a curvature or some other shape, immediately prior to surgery, to assist the
physician in introducing, advancing and steering the guidewire and catheter to the
target site in the blood vessel. The physician would simply bend the distal tip 12
of the guidewire, thus bending member 40 as well. The force needed to bend member
40 back to its original position, is greater than elastic force of core wire 20, which
wants to return the guidewire to its original position. Therefore, the distal tip
12 of the guidewire can be bent into a desired shape, and remain in that shape during
the procedure.
[0019] Guidewire 10 further includes a cover 50, which surrounds the member 40 and portions
of the core immediately adjacent thereto. Figure 1 shows the cover 50 as being a coiled
spring. Spring 50 can be made from any number of materials known in the art including
platinum, which would provide for a radiopaque distal end to the guidewire, or stainless
steel. Spring 50 includes a closely packed coils with adjacent coils separated by
a spacing or pitch distance of between 0.012-0.051 mm (0.0005 and 0.002 inches) and
an optimum or preferred spacing of 0.0254 mm (0.001 inch.) and wherein the wire forming
the spring itself has a diameter of 0.051-0.076 mm (0.002 to 0.003 inches). However,
the cover for the guidewire of the present invention need not comprise a spring. In
fact, the spring could be removed and the cover could comprise the coating 62 itself.
[0020] Cover 50 is preferably tightly wound around the core wire and member, so that it
helps retain the member 40 within the bore 30. This is advantageous because it is
often not practical to weld or apply an adhesive between materials such as Ni-Ti alloys
and stainless steel, as they are often not effective. The cover offers a good solution
for keeping the member 40 in the bore, and is economical for manufacturing.
[0021] Although particular embodiments of the present invention have been shown and described,
modification may be made to the catheter without departing from the scope of the present
invention. The terms used in describing the invention are used in their descriptive
sense and not as terms of limitations.
1. A guidewire (10) for navigating through the human vasculature, said guidewire having
a distal end (12) for insertion into the body, and a proximal end (14), said guidewire
comprising:
a) a core wire (20) having distal and proximal ends (22 and 24) and a longitudinal
axis therebetween, said distal end (22) of said core wire is formed from a superelastic
material, an outer surface (21) of said core wire having a longitudinal bore (30)
at said distal end, said bore having a predetermined size, including an axial height,
and shape; and
b) a member (40) formed from a malleable material, said member having an axial height
not substantially greater than said axial height of said bore, said member being substantially
entirely inserted within said bore, whereby after said member is bent the shape of
said distal end of said core wire changes without elastically returning to its original
shape; and
c) a cover (50) surrounding said member and portions of the core wire immediately
adjacent thereto.
2. The guidewire according to claim 1, wherein said member (40) has substantially the
same size and shape as said longitudinal bore.
3. The guidewire according to claim 1 wherein said cover (50) comprises a coiled spring.
4. The guidewire according to claim 1 further including a lubricious sleeve (62) covering
said distal end of said core wire.
5. The guidewire according to claim 4 wherein said sleeve (62) comprises polytetrafluroethylene.
6. The guidewire according to claim 4 wherein distal end (22) of said core wire (20)
includes at least one lateral groove (23) on its outer surface.
7. The guidewire according to claim 1 wherein said cover (50) comprises a polymeric sleeve.
8. The guidewire according to claim 1 wherein said cover (50) comprises a polytetrafluroethylene
sleeve.
9. The guidewire according to claim 1 wherein said core wire (20) comprises about 40
to about 49% titanium and the balance of the alloy being nickel and up to 10% of other
alloying elements.
10. The guidewire according to claim 9 wherein said other alloying elements are selected
from the group comprising of iron, cobalt, vanadium and copper.
1. Führungsdraht (10) zum Navigieren durch die menschliche Vaskulatur, wobei der Führungsdraht
ein distales Ende (12) zum Einführen in den Körper und ein proximales Ende (14) aufweist,
wobei der Führungsdraht umfasst:
a) einen Kerndraht (20) mit einem distalen und einem proximalen Ende (22 und 24) und
einer Längsachse dazwischen, wobei das distale Ende (22) des Kerndrahtes aus einem
superelastischen Material gebildet ist, eine äußere Oberfläche (21) des Kerndrahtes
eine Längsbohrung (30) an dem distalen Ende aufweist, wobei die Bohrung eine vorherbestimmte
Größe, einschließlich einer Axialhöhe, und Form aufweist; und
b) ein Element (40), das aus einem hämmerbaren Material gebildet ist, wobei das Element
eine Axialhöhe aufweist, die nicht wesentlich größer ist die Axialhöhe der Bohrung,
das Element im wesentlichen vollständig in die Bohrung eingeführt ist, wobei nachdem
das Element gebogen ist, sich die Form des distalen Endes des Kerndrahtes ändert,
ohne in seine ursprüngliche Form elastisch zurückzukehren; und
c) eine Abdeckung (50), die das Element und Abschnitte des Kemdrahtes unmittelbar
benachbart dazu umgibt.
2. Führungsdraht nach Anspruch 1, wobei das Element (40) im wesentlichen die gleiche
Größe und Form aufweist wie die Längsbohrung.
3. Führungsdraht nach Anspruch 1, wobei die Abdeckung (50) eine Keilfeder umfasst.
4. Führungsdraht nach Anspruch 1, weiter umfassend eine schlüpfrige Büchse (62), die
das distale Ende des Kerndrahtes abdeckt.
5. Führungsdraht nach Anspruch 4, wobei die Büchse (62) Polytetrafluorethylen umfasst.
6. Führungsdraht nach Anspruch 4, wobei das distale Ende (22) des Kerndrahtes (20) wenigstens
eine seitliche Rille (23) auf seiner äußeren Oberfläche umfasst.
7. Führungsdraht nach Anspruch 1, wobei die Abdeckung (50) eine Polymerbüchse umfast.
8. Führungsdraht nach Anspruch 1, wobei die Abdeckung (50) eine Polytetrafluorethylenbüchse
umfasst.
9. Führungsdraht nach Anspruch 1, wobei der Kerndraht (20) etwa 40 bis etwa 49% Titan
umfasst und der Rest der Legierung aus Nickel und bis zu 10% andere Legierungselemente
umfasst.
10. Führungsdraht nach Anspruch 9, wobei die anderen Legierungselemente aus der Gruppe
ausgewählt sind, die Eisen, Kobalt, Vanadium und Kupfer umfasst.
1. Fil de guidage (10) permettant de naviguer à travers le système vasculaire humain,
ledit fil de guidage ayant une extrémité distale (12) pour l'insertion dans le corps,
et une extrémité proximale (14), ledit fil de guidage comprenant :
a) une tige d'armature (20) ayant des extrémités distale et proximale (22 et 24) et
un axe longitudinal entre elles, ladite extrémité distale (22) de ladite tige d'armature
est formée à partir d'un matériau superélastique, une surface externe (21) de ladite
tige d'armature ayant un alésage longitudinal (30) au niveau de ladite extrémité distale,
ledit alésage ayant une taille prédéterminée, comprenant une hauteur axiale et une
forme ; et
b) un élément (40) formé à partir d'un matériau malléable, ledit élément ayant une
hauteur axiale non sensiblement supérieure à ladite hauteur axiale dudit alésage,
ledit élément étant sensiblement complètement inséré à l'intérieur dudit alésage,
moyennant quoi, après que ledit élément est fléchi, la forme de ladite extrémité distale
de ladite tige d'armature change sans revenir de manière élastique à sa forme d'origine
; et
c) un recouvrement (50) entourant ledit élément et lesdites parties de la tige d'armature
immédiatement adjacentes à celui-ci.
2. Fil de guidage selon la revendication 1, dans lequel ledit élément (40) a sensiblement
la même taille et la même forme que ledit alésage longitudinal.
3. Fil de guidage selon la revendication 1, dans lequel ledit recouvrement (50) comprend
un ressort hélicoïdal.
4. Fil de guidage selon la revendication 1, comprenant en outre un manchon lubrifié (62)
recouvrant ladite extrémité distale de ladite tige d'armature.
5. Fil de guidage selon la revendication 4, dans lequel ledit manchon (62) comprend du
polytétrafluoroéthylène.
6. Fil de guidage selon la revendication 4, dans lequel l'extrémité distale (22) de ladite
tige d'armature (20) comprend au moins une rainure latérale (23) sur sa surface externe.
7. Fil de guidage selon la revendication 1, dans lequel ledit recouvrement (50) comprend
un manchon polymère.
8. Fil de guidage selon la revendication 1, dans lequel ledit recouvrement (50) comprend
un manchon en polytétrafluoroéthylène.
9. Fil de guidage selon la revendication 1, dans lequel ladite tige d'armature (20) comprend
d'environ 40 à 49% de titane et le complément de l'alliage étant du nickel et jusqu'à
10% d'autres éléments d'alliage.
10. Fil de guidage selon la revendication 9, dans lequel lesdits autres éléments d'alliage
sont choisis dans le groupe comprenant le fer, le cobalt, le vanadium et le cuivre.